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icon Health Insurance icon Diseases icon Cancer icon Testicular

Testicular Cancer

Testosterone is what makes you a man. The loose sac that lies behind the penis and holds two eggs is what bring men to life. When these hormones go out of balance and cancerous cells start growing in and around the sac, it gives rise to testicular cancer diseases. Although lumps and cysts are generally deemed harmless, it may also result in testicular cancer depending on its characteristics.

No man is safe from testicular cancer. 1 in 250 men experience it throughout their lifetime and it affects men between the ages of 15 to 40. In fact, even men older than 50 report cases of testicular cancer around the world. You can reduce medical expenses by buying Health Insurance

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About Testicular Cancer/Overview

The testicles are the core of the male reproductive system. Resembling the size of a small golf-ball, they possess different kinds of cells which may become cancerous. Testicular cancer is curable in the majority of cases and is a commonly occurring condition in men between the twenties and thirties. Although its exact causes are unknown, there is no evidence which suggests that it is not curable.

The way testicular cancer begins is when the cells or tissues that produce immature sperm becomes cancerous. These cells start dividing and growing rapidly in an unwanted manner, slowly invading into the lymph nodes and spreading to different regions. Men of American descent are more prone to testicular cancer in the world while those of Asian and African descent have the lowest incidences. Doctors know for a fact that the risk for this disease goes up in men who have undescended testicles or anyone who has cancer in either of the two testicles.

The staging of testicular cancer determines the treatment plan to be used by patients. It is based on the TNMS System by the American Joint Committee on Cancer (AJCC) where:

  • T - represents the tumour spreading to the tissues around the testicles.
  • N -says if cancer cells have branched out into the regional lymph nodes.
  • M - if cancerous cells have metastasized.
  • S - shows levels of tumour protein producing markers in the human body.

There are four stages of testicular cancer based on the TNMS system criteria and they are:

  • Stage 0 - Tumours are called Carcinomas in Situ and the cancer cells don't spread beyond the testicles in this stage.
  • Stage 1 - Stage 1 indicates that cancer cells have spread to the surrounding tissues in the testicles but not yet to the lymph nodes. The levels of protein markers may be normal or elevated depending on the subcategories of this stage which are Stage 1A, Stage 1B, and Stage 1S respectively. Stage 1A is when the cancer cells spread to the inner layer of the testicle, 1B is when the cells reach the outer layer and affect the spermatic cord and scrotum, and 1S is when cancerous cells invade surrounding tissues nearby the testicles with elevated protein markers in the blood.
  • Stage 2 - In Stage 2, the tumour marker levels may rise or be slightly high. Cancerous cells spread out to one lymph node or more at this stage. This stage has subcategories too which define how many lymph nodes cancer spreads to and the size of each recorded in centimetres, respectively.
  • Stage 3 - When cancerous cells affect different internal organs besides the testicles and metastasize, doctors refer to it as Stage 3 testicular cancer. The liver, brain, and lungs are the most susceptible areas when these cells first start spreading.
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Fast Facts on Testicular Cancer

Here are some fast facts on testicular cancer:

  • Testicular cancer starts developing as early as 15 years old in men and affects men who are 40 and above too.
  • 1 in 250 men develops testicular cancer in their lifetime.
  • Testicular cancer is one of the most curable cancers in the world, although it may recur.
  • There are two kinds of testicular cancer - seminos (grows slowly) and non-seminos (grows and spreads rapidly)
  • Surgically removing the testicles does not cause infertility. Chemotherapy may affect the sperm count and quality in men which may lead to infertility.

When you first arrive at the hospital, your doctor will begin by evaluating your medical records and by taking a series of diagnostic tests. Diagnostic tests involved in the screening of this medical condition are:

  • Ultrasound - Ultrasound scan is used to determine the characteristics of lumps on the scrotum. A clear gel is applied and the doctor uses an ultrasound imaging probe to find out if the lumps are inside or outside your testicles.
  • Blood Tests - Certain tumour markers get elevated in the blood for cases of testicular cancer. Blood tests involve collecting a sample for analysis and evaluation of their levels.
  • Radial Inguinal Orchiectomy - If your doctor thinks the lump is cancerous, a surgical procedure known as the Radial Inguinal Orchiectomy will be carried out. In this surgery, your testicles will be removed and sent to the lab for analysis.
  • CT Scan (Computerized Tomography) Scan - CT Scan takes X-ray scans of the abdomen, chest, and pelvic areas to identify symptoms and signs of testicular cancer. It is used for staging cancer, in general.

Symptoms

Most of the symptoms of testicular cancer can be detected visually. They are:

  • A lump or enlargement in either testicle

    Any of the two testicles may swell up, enlarge or get inflamed. The lumps may be rounded, smooth or hard and the size of a pea or a marble. Pain, discomfort, and numbness are often associated with these.

  • A feeling of heaviness in the scrotum

    If either of the two testicles feels heavier than the other, it's a safe bet to consider it a symptom.

  • A dull ache in the abdomen or groin

    A numb sensation which does not accompany any pain or a dull ache in the abdomen or groin.

  • A sudden collection of fluid in the scrotum

    When fluid builds up in the scrotum without any warning.

  • Pain or discomfort in a testicle or the scrotum

    If the two testicles or either one of them pains a lot or there is discomfort. The pain may progress and may result in the testicles growing larger in size.

  • Enlargement or tenderness of the breasts

    Testicular cancer causes a dip in male hormones and increases estrogen which leads to the formation of "man breasts." Any enlargement or tenderness in these breasts serves as red flags for testicular cancer symptoms.

  • Back Pain

    Pain in the lower back may accompany difficulty in breathing, pain in the chest, bloody sputum and phlegm.

Causes

According to the medical community, there are no known causes of testicular cancer. However, some other causes may indirectly contribute towards the development of this cancer in men and they are:

  • Being exposed to harmful toxins and chemicals.
  • Klinefelter's Syndrome which is a chromosomal abnormality denoted by low levels of testosterone, small penis, and development of male breasts.
  • HIV/AIDs.
  • Viral infections in the testicles (like mumps).
  • Injuries to the testicles or scrotum or testicular torsion.
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Risk Factors

Risk factors do not mean that you're likely to be affected with testicular cancer in the future. A risk indicates a possibility and it is just that. When you have risks, the chances of you developing and not developing testicular cancer are more or less equal. Below are the most common risk factors in men:

  • An undescended testicle (cryptorchidism)

    After birth, the sac that holds the testicles descends or drops behind the penis from the abdomen. If the testicles don't appear behind the penis or are absent in the scrotum, it leads to a genital birth defect known as Cryptorchidism or undescended testes. Cryptorchidism occurs during the first three months after infancy, however, there are very rare cases where it reveals itself during early adulthood.

  • Abnormal testicle development

    Abnormal testicle development is linked to cases of testicular trauma and testicular torsion. In testicular trauma, the testes get damaged due to injuries resulting from direct contact with it such as in the case of contact sports. Testicular torsion occurs when the spermatic cord gets injured and cuts off the blood supply to the testicles, thus causing inflammation and tenderness.

  • Family History

    If your family has a history of testicular cancer, you may likely be susceptible to it in the future. Testicular cancer cases have been reported in men whose family members had it.

  • Age

    This type of cancer shows within people of ages 20 to 40. Some cases of these cases have been reported in ages 15 and above as well.

  • Race

    White people are more prone to cases of testicular cancer around the world.

Different Types of Treatment

The treatment of testicular cancer will depend on its staging. Staging is the process where the malignant tumour cells are screened to identify if they've spread and affected other internal sites in the body. A medical oncologist and an urologist work together to create a suitable testicular cancer treatment plan for patients. The treatment method opted will depend on the type of testicular cancer the patient has.

Generally, there are two types - seminomas and non-seminomas. Chemotherapy is very effective against seminomas while non-seminomas are known to spread tumour cells and affect other internal organs quickly requiring a combination of surgery and chemotherapy or other methods.

Please note that treatment options for testicular cancer may lead to infertility in some cases. It is advisable to opt for sperm banking for men who wish to bear children before undergoing testicular cancer treatment. Below are the following treatment options available for patients:

  • Surgery

    An incision is made in the scrotum and the testicles and lymph nodes are removed. Their removal ensures and prevents the malignant tumour from spreading to other areas of the body. Surgery may involve the Retroperitoneal Lymph Node procedure where the affected lymph nodes are removed to prevent cancer from metastasizing further.

    After surgery, it is recommended you opt for palliative care to attend your physical, emotional, social, and psychological needs, at least during the first few weeks after treatment. Palliative care is suitable for all ages and helps the patient to transition into everyday life and deal with the uncomfortable side effects. Palliative care happens before, during, and after the cancer treatment phases since it's a supportive and long-term healing process.

  • Radiation Therapy

    When cancerous cells divide and spread to the lymph nodes, radiation therapy is used to eliminate and slow their growth. The procedure uses high-powered energy beams and targets specific regions of the body which is popularly referred to as external beam radiation. Before the treatment, the angle the beams are fired and the way a patient is placed is carefully taken into consideration. Seminoma is sensitive against radiation therapy which is why it's used to treat it. Side effects involved in radiation therapy include nausea, fatigue, redness, and irritation in the groin and abdominal sections.

  • Chemotherapy

    Chemotherapy uses drugs in pill or intravenous injection form to treat testicular cancer patients by killing cancer cells. These drugs travel throughout the body and specifically target cancer cells, breaking them away from the lymph nodes and other regions. Chemotherapy treatment is reserved for patients who have had their testicles removed and have a possibility of cancer coming back later post-surgery. It is also effective in the mid or the early stages of testicular cancer treatment. The treatment protocol lasts for 3 to 4 weeks and drugs like Cisplatin, Etoposide, Bleomycin, Vinblastine, and Paclitaxel are used. Combination drugs are more effective than standalone choices in chemotherapy treatments.

    The downside to chemotherapy is that it features a host of side effects. Since the drugs lead to eliminating the division and growth of cancerous cells, they may affect the cell growth in other areas of the body such as the bone marrow, hair follicles, and the lining of the mouth/intestines, thus leading to more complications. Side effects associated with chemotherapy are fatigue, lack of appetite, diarrhoea, nausea, hair fall, bleeding, and lowered count of white blood cells which causes infections. Some of the drugs in chemotherapy may also cause kidney damage, shortness of breath, bladder bleeding, lung damage, and numbness/reduce sensitivity in the hands/feet. Other rare side effects with chemotherapy treatment are higher cholesterol level, increased heart problems, and incidences of leukaemia.

    These side effects are transitory and fade away after the end of the treatment but, some of them may last for a lifetime or cause permanent damage. It is advisable to contact your treatment team immediately when you notice such side effects so that the changes are made early and the effects become reversible.

  • Surveillance

    Surveillance is prescribed to patients post-surgery. It is a type of monitoring where you meet up with the doctor and get a regular physical examination done. Depending on the type of testicular cancer (seminoma or non-seminoma), surveillance may last for a few months to up to 5 years with ongoing doctor appointments. Your doctor may prescribe blood tests, chest X-rays and occasional CT scans if they suspect cancer to produce tumour proteins.

    If your risk for recurring testicular cancer is high, your doctor may recommend chemotherapy treatment unless the risk of cancer coming back is low.

  • High-Dose Chemotherapy with Stem Cell Transplant

    Testicular cancer patients respond well to chemotherapy. However, high-dose chemotherapy carries the risk of damaging the bone marrow which is responsible for creating new blood cells. When the bone marrow is damaged, bleeding, problematic infections, and life-threatening complications occur. The way around this is stem cell transplant which lets the doctors use higher doses of chemotherapy without affecting the bone marrow. The stem cells in the bone marrow are collected using a special equipment via the bloodstream and are stored after freezing. Once the patient undergoes high-dose chemotherapy treatment, these stem places are settled back into the bone marrow and start functioning properly again in a few weeks.

    High-dose chemotherapy with stem cell transplant is reserved for patients who have recurring cases of testicular despite previous chemotherapy treatments. Talk to your doctor about any associated side effects in regard to this procedure before opting it.

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Prevention

You cannot prevent testicular cancer from progressing or halt it in its tracks right way. The only way to treat it is to identify its symptoms and seek a medical opinion. Self-examination is the first step towards diagnosis of its symptoms, however, in most cases self-examination alone isn't sufficient.

On the other hand, if you want to safeguard yourself from testicular cancer before it even starts developing, here are a few things you could do:

  • Avoid exposure to harmful chemicals and toxins.
  • Eat an immune-boosting diet and foods like fruits, vegetables, nuts, seeds, and berries. Going vegan helps.
  • Exercise every day, get your daily sunshine, and reduce stress levels through activities like drawing, painting, cycling, walking in nature, etc.
  • Make sure your liver is in tiptop shape and go through a detox or cleansing plan. Cancer patients usually experience impaired liver functioning, according to famous cancer physician Max Gerson.

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Conclusion

Life doesn't end at testicular cancer. The bright side is that it's absolutely curable and there are several treatment options these days. It can be cured even before it's discovered or in its later stages. According to the Testicular Cancer Resource Center, 70% of cases linked to Stage I Non-seminoma and Stage I Seminoma are curable via Orchiectomy alone.

If you're going under the knife for testicle removal, you don't have to worry since your fertility won't get affected. You'll still be able to have kids, lead a normal life and not worry about that malignant tumour ruining your life. If you're open to options and experimentation, you may try opting for clinical trials where the doctors conduct new methods of treatment to fight and cure testicular cancer. Clinical trials are known to carry risks since they involve untested or unapproved methods for the purpose of leading to medical innovations or discoveries.

For more information, talk to your doctor and assess the available treatment options depending on your case.

Disclaimer: The tips & exercises suggested are the personal opinions of the writer. Kindly consult a licensed physician/dietitian/practitioner before implementing the same.

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Frequently Asked Questions

  • Q. What is usually the first sign of testicular cancer?

    • The first sign of testicular cancer are the lumps that form around the testicles, that may be painful or painless which usually accompanies swelling as time progresses. When placed on the palm of your hand, you may notice your testicles to be of different sizes. The shape and consistency also changes and these are the first few telltale signs of testicular cancer.

  • Q. What is the survival rate of testicular cancer?

    • The survival rate for testicular cancer cases is men is 95% in a 5-year timeline. According to The American Cancer Society in the United States, it is estimated that 400 deaths will occur this year from testicular cancer alone.

  • Q. What does the lump feel like in testicular cancer?

    • The lump in the testicular cancer may feel painless and uncomfortable. It may be the size of a pea or marble and you may experience pain or a numb sensation when rolling your fingers on it. Its size may increase and lumps may be hard, bumpy, or rounded.

  • Q. Can you die from testicular cancer?

    • Yes, you may die from testicular cancer if the benign tumour spreads to other parts of the body and progresses to the advanced stages. It's best to get treated early.

  • Q. How do I check myself from testicular cancer?

    • Start off by checking one testicle at a time. Hold the testicle between your thumb and fingers and roll it up to visually spot any lumps or inconsistencies in the shape and size. If you notice any rounded bumps, hard lumps, or any changes in the sizes of your testicles, book an appointment with a certified urologist immediately. When checking yourself, take a warm shower to relax the scrotum and make the visual inspection easier and private.

  • Q. What testicular cancer lump feels like?

    • The cancerous lump will feel painful or painless. The key factor here is its size which may be of a pea or a marble. The lump may be tender and accompany swelling and its edges may be hard or rounded.

  • Q. Does testicular cancer spread quickly?

    • It depends. If it's a seminoma case, the cancerous cells will grow very slowly but if it's a non-seminoma cancer, the cells grow fast and divide rapidly. Cancer may spread quickly if it affects other internal organs in your body and its progress depends on its staging.

  • Q. What happens when testicular cancer goes untreated?

    • In layman's terms, if the testicular cancer goes untreated, then the patient dies in extreme cases. Cancer spreads to different parts of the body through the lymph nodes, resulting in death in its final stages.

  • Q. What are the warning signs of testicular cancer?

    • The warning signs of testicular cancer are the lumps and the size/shape of the testicles. Any unexplained pain in the groin or abdomen area followed by shortness of breath are the general warning signs.

  • Q. What is the most common symptom of testicular cancer?

    • The most common symptom of testicular cancer is the swelling and lump. Lumps may be due to infection and are generally harmless, but it is advisable to visit an urologist to test and confirm your suspicions. Other symptoms include shortness of breath, pain in the chest, and coughing blood from the mouth after cancer starts spreading into the lymph nodes and beyond.

  • Q. Is testicle cancer curable?

    • Yes! The good news is that testicular cancer is 100% curable when detected early. Even in advanced stages, it's never too late if you seek the right treatment options.

  • Q. Can testicular cancer be cured?

    • Yes, testicular cancer can be cured without any adverse side effects.

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